More than 60% of nurses say they have suffered the side-effects of work-related stress, such as physical or mental health problems in the past year.
Two thirds also warn that their ward or team is regularly short staffed and most nurses report that they are under more pressure than they were 12 months ago, according to the findings from our latest annual survey on the state of nursing.
“l am nearly on my knees with the level of work l have. l am beyond exhausted and have gone off with stress today”
The survey, carried out earlier this month and involving over 700 nurses, reveals the impact and extent of the nursing shortage on those working at the frontline.
One respondent said: “The majority of nurses would not enter into nursing if they were doing so in the current conditions. We are at breaking point.”
Another added: “These are grim times and patients are not getting the care they deserve.”
Asked to rate staffing levels in their ward or team, 66% of respondents said they were either always short-staffed or short-staffed more than once a week. Only 14% said they were rarely or never short staffed.
But perhaps more tellingly, 78% said they were under more pressure at work than this time 12 months ago, with 49% of respondents reporting that the pressure was “significantly more”.
More than three quarters said they regularly worked more than their allotted hours, with 13% saying they often worked more than 10 additional hours a week.
One respondent described how registered staff on night duty were being asked to look after 15 each.
The impact of such pressures is being translated into falling morale and increased sickness, the survey results suggest.
A third of respondents to the survey said morale was already bad and had got worse over the last 12 months in their unit, ward or team. A further quarter said that while morale was currently good, it was starting to deteriorate.
“Morale is at an all time low and I am seriously considering leaving the profession I once loved,” said one respondent. “I feel that I am compromising patient care and safety.”
Another said: “All the nurses and healthcare givers I work with are excellent nurses and very capable of delivering excellent patient care where care and compassion is at the centre. Unfortunately the time pressure often is so high that there simply is no extra capacity to really listen to your patient and provide that little bit extra that often makes all the difference.”
“I left due to stress and ill health from the pressure placed on me”
Perhaps most worryingly, 63% of respondents told us they had suffered physical or psychological side-effects of stress in the past year.
A respondent, who described themselves as a health visitor, said: “l am nearly on my knees with the level of work l have most of which is in safeguarding. l am beyond exhausted and have gone off with stress today. Now l am worried about my clients and my colleagues.”
Another said: “I have recently left my position as a band 7 neonatal nurse, after 17 years working for the same hospital. I left due to stress and ill health from the pressure placed on me.”
Meanwhile, 28% of those who completed the survey said they took more sick leave last year, though 55% reported no change and the remaining 17% took less.
There have been well documented problems this year for trusts attempting to fill extra posts created in the wake of the Francis report into care failings at Mid Staffordshire Foundation Trust.
Ministers have been keen to trumpet a rise in hospital nurse numbers climb of 5,000 – though evidence suggests this trend has stalled recently – and the NHS workforce has been swelled by staff recruited from overseas.
Three quarters of survey respondents said it had been difficult or almost impossible to recruit new staff, with only a quarter noting no problems with recruitment. A third said nurses from overseas had been actively recruited by their employer to join your ward, unit or team over the last 12 months.
“These are grim times and patients are not getting the care they deserve”
The survey also highlighted problems retaining staff, with 61% reporting difficulties keeping the existing workforce.
We also asked about the impact of the new rules on staffing transparency in England, which came into force in June, and require wards to publish data on actual versus planned staffing levels.
The rules, along with new guidance on safe staffing in general acute wards from the National Institute for Health and Care Excellence, have been introduced in response to last year’s Francis report.
In a minority of places, the ward staffing data appears to have begun to have a positive effect, according to respondents.
Around 13% said they had resulted in staffing levels increasing but more are still needed for a safe ratio, while 3% said they had seen staffing levels increase to a safe ratio to beds/patients. However, 39% the impact had been negligible, with staffing levels remaining the same.
“This survey is further evidence that more must be done to improve nurse staffing levels”
Peter Carter, chief executive and general secretary of the Royal College of Nursing, said: “This is truly a desperate state of affairs – it’s not a crisis in the making, it’s a crisis right now.
“Nursing staff are committed to caring for their patients but are being driven to breaking point by unbearable work pressures,” he said.
“Nurses are very concerned by continuing problems with short staffing on the frontline,” said Mr Carter. “When there aren’t enough nurses available to care for the increasing number of patients the quality of care can be compromised.
He added: “It’s an incredibly difficult and demoralising situation for nurses and potentially dangerous for patients. This survey is further evidence that more must be done to improve nurse staffing levels.”
|1. How would you rate staffing levels on your ward or team?|
|We are always short-staffed||38.52%|
|We are short-staffed more than once a week||27.93%|
|We are short-staffed once a week||9.63%|
|We are short-staffed once a fortnight||3.85%|
|We are short-staffed once a month||5.46%|
|We are rarely short-staffed||13.32%|
|We are never short-staffed||1.28%|
|2. Do you feel you are currently under more or less pressure at work than you were this time 12 months ago?|
|A bit more||29.75%|
|About the same||18.51%|
|A bit less||1.42%|
|3. Do staff on your ward or team have sufficient time to provide safe and adequate handover to colleagues?|
|Yes, but rarely||18.12%|
|4. Has your ward, unit or team got more or less permanent registered nursing staff than it did 12 months ago?|
|A lot more||1.95%|
|A few more||14.94%|
|A lot fewer||15.10%|
|5. How easy or difficult has it been for your ward, unit or team to fill vacant nursing posts over the last 12 months, in your opinion?|
|It has been very easy to recruit new staff||5.28%|
|It has been fairly easy to recruit new staff||18.56%|
|It has been fairly difficult to recruit new staff||27.36%|
|It has been very difficult to recruit new staff||24.32%|
|It has been almost impossible to recruit new staff||8.32%|
|6. How easy or difficult has it been for your ward, unit or team to retain existing nursing staff over the last 12 months, in your opinion?|
|It has been very easy to retain existing staff||9.81%|
|It has been fairly easy to retain existing staff||25.24%|
|It has been fairly difficult to retain existing staff||31.83%|
|It has been very difficult to retain existing staff||15.92%|
|It has been almost impossible to retain existing staff||6.27%|
|7. Have nurses from overseas been actively recruited by your employer to join your ward, unit or team over the last 12 months?|
|8. If you currently work in the UK, have you been tempted to nurse overseas yourself over the past 12 months?|
|Yes, I’ve filled in the forms and gone||0.96%|
|Yes, I’ve seriously considered it||12.52%|
|Yes, I’ve thought about it but not seriously||16.53%|
|9. How best would you describe morale in your ward, unit or team over the past 12 months?|
|Bad and getting worse||33.60%|
|Bad and always has been||7.52%|
|Bad but starting to improve||9.76%|
|Neither good nor bad||12.48%|
|Good but starting to deteriorate||25.28%|
|Good and always has been||9.60%|
|Good and getting better||1.76%|
|10. What effect, if any, have the new rules on staffing transparency introduced by NHS England in June had on staffing levels in your ward, unit or team?|
|They have resulted in staffing levels increase to a safe ratio to beds/patients||2.42%|
|They have resulted in staffing levels increase but more are still needed for a safe ratio||12.12%|
|They have had a negligible impact, with staffing levels remaining the same||39.74%|
|They have resulted in staffing levels reduce because we were previously overstaffed||1.13%|